The effect of nortriptyline in elderly patients with cardiac conduction disease.
Ten depressed, elderly patients with cardiac conduction abnormalities were given therapeutic doses of nortriptyline. Serial ECGs revealed no clinically significant adverse cardiac changes. These data, added to the findings of previous research, suggest that tricyclic antidepressants (TCAs) present little risk in patients with first degree atrioventricular block or hemiblock. Patients with bundle-branch block and bifascicular block are at greater risk of adverse cardiac sequelae but can be treated with TCAs. To maximize safety, the authors recommend monitoring serial ECGs and plasma TCA levels.
Dietch
J T
JT
Department of Psychiatry, University of California--Irvine Medical Center, Orange 92668.
Fine
M
M
D000368:Aged; D000369:Aged, 80 and over; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000097:blood; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology*; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006327:Heart Block / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000009:adverse effects* / Q000097:blood; D012307:Risk Factors
D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline